Provider Demographics
NPI:1790349314
Name:MELL, ANNIE SALENE (LCMHC, LPC, ATR-BC)
Entity Type:Individual
Prefix:MRS
First Name:ANNIE
Middle Name:SALENE
Last Name:MELL
Suffix:
Gender:F
Credentials:LCMHC, LPC, ATR-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:417 HIBBARD RD
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:VT
Mailing Address - Zip Code:05468-9600
Mailing Address - Country:US
Mailing Address - Phone:407-579-4227
Mailing Address - Fax:
Practice Address - Street 1:417 HIBBARD RD
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:VT
Practice Address - Zip Code:05468-9600
Practice Address - Country:US
Practice Address - Phone:407-579-4227
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-29
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0015099101YM0800X
VT068.0134681101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health